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Cosmetic surgeons can be found in all kinds of places. Ads in your local paper or on radio are a place to start if you don't have a personal referral. However, a doctor with a national chain of clinics advertised on late night TV may be too commercial and too busy to give you the best personal care.

I suggest having consultations with at least two or three physicians, using the guidelines in this chapter to help make your decision. Although some doctors charge for these initial visits, this is less common as the field becomes more competitive. Whether or not the doctor charges implies very little about his competence. Some physicians charge to "weed out" people who aren't serious.

How to React to Badmouthing and Puffery

Several of the national hair transplantation chains and at least one specialty board have taken aggressive positions about the incompetence of other physicians (badmouthing). You may also encounter individuals claiming that they are the absolute best (puffery). Unfortunately there seems to be more of this behavior in cosmetic surgery than other medical fields. It is extremely unprofessional and violates medical ethics.

Physicians are theoretically trained early in medical school to respect other doctors and not to criticize their colleagues. We are a select group who've worked very hard for our positions. Most of us understand that criticizing other doctors destroys the trust of patients for the entire medical delivery team. If you encounter badmouthing, ask yourself who it reflects on. As Shakespeare said, "The fragrance of the rose lingers on the hand that casts it." Other kinds of smells linger too.

Puffery is not as bad (we doctors are full of ourselves as you well know), but it is also unprofessional. Medical knowledge is widely spread through journals and training, and any individual or any group who claims they're the "best and only" should be tried and convicted of total egomania.

Insurance Billing for Cosmetic Procedures is Fraud

And both the doctor and the patient could go to jail! Be wary of a "deal" to do cosmetic surgery along with another medical procedure for which the insurance is billed. A few procedures, such as some breast reconstruction or liposuction for overly large breasts and functional nose and eyelid work, can sometimes be covered by health insurance. Remember that you, as well as the physician, have a relationship with the insurance company, and you are responsible for keeping that relationship as ethical as possible. And if you report an insurance fraud or attempted insurance fraud by a physician, you may even be rewarded financially by the insurer.

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